The plantar fascia provides tough, band like fiber from the attachment to the ball of the foot. It functions to provide protection to the underlying muscles, tendons, arteries, and nerves. The fascia assists in the maintenance of the foot arch and keeps the foot in relative supination through the push-off phase of ambulation. During a heel strike, the plantar fascia remains supple and allows the foot to adjust to the ground surface and absorb shock. Then, during the toe-off phase of ambulation, the plantar fascia becomes tight and thereby creates rigidity for the foot to facilitate forward movement.
Plantar fasciitis , the most common cause of heel pain in adults, typically results from repetitive use or excessive load on the fascia. Persons who are overweight, female, or older than 40 years or who spend long hours on their feet are especially at risk for developing plantar fasciitis. Athletes, especially joggers and runners, also develop plantar fasciitis.
Tightness of the Achilles tendon contributes to increased tension on the plantar fascia during walking or running and is therefore an important contributor to plantar fasciitis.
Mechanical causes of heel pain are generally synonymous with plantar fasciitis, but some cases are enigmatic in etiology and are deemed idiopathic. Although the word fasciitis implies inflammation, recent research indicates that it is more likely to be a noninflammatory, degenerative process that might be more appropriately called plantar fasciosis.
Acute onset of severe plantar heel pain after trauma or vigorous athletics may indicate rupture of the plantar fascia. The patient may have heard a “pop” or felt a tearing sensation. Findings suggestive of rupture include a palpable defect at the calcaneal tuberosity accompanied by localized swelling and ecchymosis.
Most people will experience shoulder pain and discomfort when calcific tendonitis develops.
The pain from calcific tendonitis is usually concentrated in the front or back of a person’s shoulder and down into the arm.
Some people may experience severe symptoms. They may be unable to move their arm, and the pain can interfere with sleep.
As the calcium deposits build up in stages, the pain a person feels may come on suddenly or increase slowly and gradually.
The three stages are known as:
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Pre-calcification. The body undergoes cellular changes in the areas where the calcium will eventually build up.
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The calcific stage. Calcium releases from the cells and begins to build up. During this stage, the body reabsorbs the calcium buildup, which is the most painful part of the process.
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The post-calcific stage. The calcium deposit disappears, and a healthy tendon takes its place.
However, it is possible to have the condition without any noticeable symptoms.
If conservative treatment for plantar fasciitis fails to alleviate symptoms, or you are just tired of the PAIN.
Extracorporeal Shockwave Therapy
Is an Effective Alternative to Podiatric and Orthopedic Surgery.
High-Energy Shockwave is a relatively new treatment option in orthopedic, podiatric and cardiovascular medicine. The effect of shockwaves was first documented during World War II when the lungs of castaways were noted to be damaged without any superficial evidence of trauma. It was discovered the shockwaves created by depth charges were responsible for the internal injuries with no damage to any of kind. This created a great deal of interest and research into the biological effects of shockwaves on living tissue. The first medical treatment developed from this research was lithotripsy. This allowed focused shockwaves to essentially dissolve kidney stones without surgical intervention. Today, over 98% of all kidney stones are treated with this technology. The use of shockwaves to treat tendon related pain began in the early 1990s.
High Energy Shockwaves produces an acoustic soundwave from a sonic blast, focused energy at the injury site in the painful areas where the injury of the chronic condition occurs.
This energy promotes regeneration and reparative processes of the tendons, bone soft tissues.
What Happens to Calcium Deposit?
We are asked all of the time, what happens to the calcium deposit or spurs that are blasted with the High-Energy ShockWaves. While calcium build-up is most often a result of micro-tears or other trauma to a tendon, some have a spur come out as a natural mechanism that actually injures the injury more adding extreme PAIN. The calcific spur actually resorbs back in the system the same way that they came out when the injury occurred. Acoustic waves break up the existing calcifications with micro blasts. High-Energy Shockwave Therapy starts the biochemical decalcification of the calcific build-up while it treats the tendon ie, injury. The granular particles of calcium are then removed by the lymphatic system. We have seen it on follow up imaging, where the deposits are gone once the injury has been properly healed.
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